Organization
ROANENTEPRISES, LLC
Active
Other names
180 Boys Adolescent Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN VAN ROANE (PRESIDENT/CEO)
(804) 349-6382
Entity
Organization
Contact information
Practice address
3122 W CLAY ST, RICHMOND, VA 23230-4728
(804) 213-0540
(804) 213-0542
Mailing address
PO BOX 322, RICHMOND, VA 23218-0322
(804) 213-0540
(804) 213-0542
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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